Mr Hide Yamamoto is a consultant urologist for Wells Health.

 

How common is prostate cancer?

Prostate cancer is one of the most common cancers in men. In the UK, around 1 in 8 men will be diagnosed with prostate cancer in their lifetime.

What are the symptoms of prostate cancer and when should I be seen?

Symptoms may include frequent urination, difficulty starting or stopping urination, pain when urinating, blood in the urine or semen, and pain in the lower back, hips, or pelvis. If you experience any of these, it's important to see a doctor but early prostate cancer often has no symptoms.

How often should I get checked?

Screening is not routinely offered to all men, but those at higher risk (e.g. over 50 or with a family history) may be offered tests. It's advisable to talk to a GP about when and how often you should get checked, based on your individual risk.

What is the role of a urologist in a prostate cancer diagnosis?

A urologist specialises in the urinary tract and male reproductive organs. They play a key role in diagnosing prostate cancer, conducting tests (e.g. PSA blood test, biopsies) and providing treatment options such as surgery or other therapies.

What are some treatments for prostate cancer?

Treatments depend on the cancer's stage and grade. Common options include surgery (e.g. prostatectomy), radiation therapy, hormone therapy, chemotherapy and active surveillance for low-risk cases.

What are the most common risks associated with prostate cancer surgery?

Risks include urinary incontinence, erectile dysfunction, infection, and bleeding. These risks vary depending on the type of surgery, surgeon experience and the individual's health.

Who is at higher risk of prostate cancer?

Men over 50, those with a family history of prostate cancer, black ethnicity, and those with certain genetic mutations (e.g. BRCA1 or BRCA2) are at higher risk.

 

About Mr Yamamoto, Consultant Urologist

 

Tell us about your role and your expertise

I specialise in treating men with prostate cancer and those suffering with enlarged prostates.  My surgical expertise includes robotic-assisted radical prostatectomy, which treats prostate cancer by entire removal of the prostate, and laser prostate surgery which is a great operation to help men empty their bladder.

My Yamamoto wears a dark blue suit, white shirt and dark blue tie, with a green lanyard. He is standing, turning slightly to his left to face the camera. I perform around 80 robotic-assisted prostatectomies every year and also oversee all the urgent referrals for suspected prostate cancer in west Kent, which manages approximately 2,000 referrals each year.

These men may be offered an MRI which assesses for suspicious areas inside the prostate. These areas are then sampled using a needle, in a procedure called a biopsy.

How is the surgery carried out?

I offer patients robotic keyhole surgery using the da Vinci robot. The prostate is in a very tight space and the aim is to free it from the surroundings without causing any damage and while taking out the cancer properly.

It is both science and art as every patient has a unique anatomy. Fortunately, the vast majority of men will be cured after this procedure and get back to their normal lives within a few weeks.

Are there any advancements in diagnosis and treatment that will improve outcomes for patients?

We are constantly making improvements in the safety and efficacy of diagnosis and treatments.

Until recently, complications included infection and severe urine incontinence after surgical treatment. Fortunately, advances in our knowledge and techniques have led to significant improvements both following diagnosis and treatment.

Serious infections now almost never occur after prostate biopsy, and we are so much better at detecting cancer when patients are assessed using MRI and target biopsies. Complications such as long-term incontinence are very rare in my own experience of robotic surgery.  

We are now more selective in deciding who to treat, as many will have less aggressive cancers which could simply be observed.

General improvements in outcomes are also seen in other treatments for prostate cancer so it has become much easier for patients to live with or without treatment for prostate cancer compared to 10 years ago.

What might change in the near future is how we find prostate cancer. Early discovery has been shown to save lives but we don’t yet have a funded national screening programme. It is important to remember any man can request a PSA blood test through their GP, even with no symptoms. You may wish to consider an online risk calculator to determine whether you should have your PSA tested.